Twelve Step approaches to drug and alcohol treatment dominate the treatment industry in the United States. As much as 90% of inpatient and intensive outpatient treatment facilities advocate some sort of 12-step involvement. Twelve step facilitation treatment or twelve step facilitation therapy is essentially a form of psychoeducation about the benefits of working a 12-step program. In Intensive Outpatient Programs 12 step goals and objectives will be integrated into all patients’ treatment plans. For example, in order to complete treatment individual patients or clients will need to accomplish goals like 1) attend a certain amount of meetings per week, 2) select a home group, 3) obtain a sponsor or temporary sponsor, 4) work the first second and or third step and 5) call or socialize with a certain amount of recovering folks who identify as sober and in recovery.

While we believe these are laudable goals and objectives and very important for any person wanting to be in recovery to explore, many individuals do not feel ready or comfortable to explore these programs early in their attempts to make changes. We encourage people to learn as much as they can about these programs and we can teach folks how to navigate them, how to find meetings that are a good match for them and what are the advantages of the 12-step approach. We won’t push this approach on clients though. We will challenge clients to see if their “resistance” to 12-step programs is meaningful and if it is then we will help uncover the obstacles preventing them from getting the most from meetings. For example, sometimes people don’t like meetings because it reminds them of their own depression. Sometimes people get hung up on the emphasis on God and sometimes people dislike the concepts of “powerlessness,” the disease model, or “suffering from an incurable and chronic illness from which there is no known cure.” While these concepts are daunting to some, many people are able to find loopholes, personal understanding and flexibility and agnostic and atheist friends and meetings which more than meet their individual needs.

For clients and patients who ultimately decide that Alcoholics Anonymous is not for them we don’t want to throw the baby out with the bathwater. There are reasons why 12-step programs work that mostly have to do with the social support that AA can provide. There are several other programs which offer social support including SMART recovery, Rational Recovery, and Hip Sobriety However there is no substitute for long term individual outpatient psychotherapy which should always be used in addition to these sorts of support groups.

If you are looking for an alternative approach to 12-step approaches we recommend that you read George Vaillant’s famous research paper, Alcoholics Anonymous: Cult or Cure A Harvard research psychiatrist, Dr Vaillant demonstrated that recovery has to have four essential elements for people to become healthy, sober or achieve non substance related disorders. Those elements are: 1) structure and supervision 2) social support of friends, significant others or family 3) spirituality however that is defined by you and 4) a non drug or alcohol alternative to addiction…things that give meaning and purpose to one’s life. Individuals grappling with addiction and recovery need to learn how to replace their addictive behaviors with these curative factors.

If you are willing to try 12-step meetings we highly recommend it. It appears to work for about 1 million people in the United States in any given year. It is by far the least expensive form of support that exists. We often like to joke that you can spend 3 dollars a day and get the best education about addiction and recovery by spending several hours a day attending meetings and dropping three dollars in the baskets of three AA meetings each day. Or we can help in finding you a rehab that costs 500 times that and afterward you will still have to come home and make new sober friends and navigate the rooms of 12-step programs. Even if you decide AA is not for you, it makes good sense to give it a real college try because you will learn so much, you will be challenged, meet new people and consider all sorts of ways to change your drinking behavior. In our opinion that is a win win. Even if you get “addicted” to or “dependent” on it for a year you can always wean yourself later and it’s a lot better than being dependent or addicted to alcohol or substances. Besides, being dependent on a program and establishing friendships and relationships that develop are all part of normal healthy relationship development which is necessary in recovery. Probably there is nothing more therapeutic and powerful than the therapeutic effectiveness of one person helping another, of one alcoholic helping another, which in AA is considered to be “beyond parallel.”

Support Groups – 12 Step meetings and how to find them

Southeastern Pennsylvania InterGroup Association of Alcoholics Anonymous (SEPIA) – Administers and coordinates the Alcoholics Anonymous groups in Southeastern Pennsylvania (Philadelphia, Bucks, Chester, Delaware, and Montgomery Counties) 215-923-7900

Alcoholics Anonymous (AA) – Primarily for the alcoholic person, although others are welcome to attend “open” meetings (“closed” meetings are for alcoholics only).

Al-Anon / Alateen – Al-Anon is for the spouse/partner and other affected adults of the alcoholic person, while Alateen is for the children of alcoholics.

Adult Children of Alcoholics World Service Organization, Inc. – For people who grew up with an alcoholic parent(s) or in a dysfunctional household and who want to learn how this has affected their choices and eradicate the unhealthy patterns they have learned to cope.